| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $1,409.04 | $8,539.35 | |
Cigna
| Facility | $858.77 | $858.77 | $858.77 | |
Cigna
| Facility | 62 | $526.61 | $526.61 | $526.61 |
Cigna
| Facility | AS | $84.26 | $84.26 | $84.26 |
United
| Facility | $7,448.00 | $7,448.00 | $7,448.00 |